Human Milk Banking in North America - Risks and Mitigation

Risks and Mitigation

Two concerns are often raised by potential donor milk recipients and health care providers regarding potential risks of using banked human milk:

1. Viruses, including HIV, have been shown to transmit through breast milk. However, as mentioned above, breast milk donors are screened very carefully. In addition, each batch of milk is screened and pasteurized and retested for the presence of bacteria. "There have been no documented cases of disease transmission from donor milk provided by a milk bank operating under standard practice." (Arnold, 1999, p. 3) All of the milk banks listed below abide by the Guidelines of HMBANA. Potential donors are excluded from donating under the following circumstances:
   • Receipt of a blood product or blood transfusion, or a tissue or organ transplant within the last 12 months.
   • Regular use of more than 2 ounces of hard liquor or its equivalent in a 24 hour period.
   • Regular use of over-the-counter drugs or systemic prescriptions (replacement hormones and some birth control hormones are acceptable).
   • Use of mega-dose vitamins and/or pharmacologically active herbal preparations.
   • Total vegetarians (vegans) who do not supplement their diet with vitamins.
   • Use of illegal drugs or tobacco products.
   • Silicone breast implants
   • A history of hepatitis, systemic disorders of any kind or chronic infections (e.g. HIV, HTLV, TB) (Arnold, 1999)
2. Some of the worthwhile components of breast milk are compromised in the pasteurization process. However, many are not. "Donor milk retains its bioactivity despite partial or complete loss of some components" (Arnold, 1999, p. 3). The enzymes in breast milk (e.g. lipase) appear to be most affected by the heat. However, immune factors are less sensitive to heat and growth factors and fatty acids are stable at pasteurization temperatures. The lower the temperature at which safe processing can take place the better (Arnold, 1999). HMBANA Guidelines reflect careful research in this area.